Differentiation of ductal carcinoma in-situ from benign micro-calcifications by dedicated breast computed tomography

Abstract

Purpose Compare conspicuity of ductal carcinoma in-situ (DCIS) to benign calcifications on unenhanced (bCT), contrast-enhanced dedicated breast CT (CEbCT) and mammography (DM). Methods and Materials The institutional review board approved this HIPAA-compliant study. 42 women with Breast Imaging Reporting and Data System 4 or 5 category micro-calcifications had breast CT before biopsy. Three subjects with invasive disease at surgery were excluded. Two breast radiologists independently compared lesion conspicuity scores (CS) for CEbCT, to bCT and DM. Enhancement was measured in Hounsfield units (HU). Mean CS ± standard deviations are shown. Receiver operating characteristic analysis (ROC) measured radiologists’ discrimination performance by comparing CS to enhancement alone. Statistical measurements were made using ANOVA F-test, Wilcoxon rank-sum test and robust linear regression analyses. Results 39 lesions (17 DCIS, 22 benign) were analyzed. DCIS (8.5±0.9, n=17) was more conspicuous than benign micro-calcifications (3.6±2.9, n=22; p<0.0001) on CEbCT. DCIS was equally conspicuous on CEbCT and DM (8.5±0.9, 8.7±0.8, n=17; p=0.85) and more conspicuous when compared to bCT (5.3±2.6, n=17; p<0.001). All DCIS enhanced; mean enhancement (90HU ±53HU, n=17) was higher compared to benign lesions (33 ±30HU, n=22)(p<0.0001). ROC analysis of the radiologists’ CS showed high discrimination performance (AUC=0.94) compared to enhancement alone (AUC=0.85) (p<0.026). Conclusion DCIS is more conspicuous than benign micro-calcifications on CEbCT. DCIS visualization on CEbCT is equal to mammography but improved compared to bCT. Radiologists’ discrimination performance using CEBCT is significantly higher than enhancement values alone. CEbCT may have an advantage over mammography by reducing false positive examinations when calcifications are analyzed.

Clinical Feasibility of Reduced Field-of-View Diffusion-Weighted Magnetic Resonance Imaging with Computed Diffusion-Weighted Imaging Technique in Breast Cancer Patients

“…Moreover, DBT is vulnerable to axillary evaluation, which is essential in the preoperative evaluation. CEDM, CBBCT, and CEDBCT improved cancer diagnosis with high sensitivity and reduced false positive rate in recent studies [40][41][42][43][44][45][46][47][48][49]. Furthermore, virtual monoenergetic images acquired by using dual-layer spectral detector CT could be also useful in the diagnosis of breast cancers in patients who cannot have a breast MRI performed [50].…”

Quantitative evaluation of redox ratio and collagen characteristics during breast cancer chemotherapy using two-photon intrinsic imaging

“…Currently, a variety of imaging techniques, such as computed tomography (CT) [7,8], positron emission tomography (PET) [9,10], and magnetic resonance imaging (MRI) [11,12] are used to examine changes in the breast tumors after preoperative chemotherapy, but those examination results are inconsistent with the results of pathological analysis. CT involves a high dose of harmful radiation.…”

Investigation of x-ray spectra for iodinated contrast-enhanced dedicated breast CT

“…[25][26][27] Recently, a few clinical studies with iodinated contrast-enhanced dedicated BCT have been performed and results have been very encouraging. 24,28 A number of previous studies [29][30][31][32][33][34] have evaluated preferred kV settings and added filtration for BCT. Only a few of these studies considered optimal kV settings for iodinated contrastenhanced BCT applications.…”